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DRIVEWAY PERMIT APPLICATION ri4q1Lt�T _ J,/ <br /> r f ' _,/ <br /> Town of Verona, Dane County, Wisconsin � <br /> ,-,,,, 7 ,/% <br /> TO: TOWN OF VERONA DATE: /1(2, -- <br /> ;2, - / L) <.�c <br /> c/o Town Clerk <br /> Verona, Wisconsin 53593 <br /> (1) Name and Address of Applicant: ,//AN f 1?E D LN a t/R(z <br /> (2) Location of Driveway: of /` /11,617,5 ) 0g ROAD -' App,i7U <br /> f4-S r or l=;z I r4 RD. y i v A/o I? j ,s ;17 o f RIvrr I PE is P. <br /> (3) Legal Description of Property: <br /> f R/h r_ I? pr w N 1 .c •Ih M is pRilf tr.i-, r 1 <br /> (4) Driveway Width: 016 <br /> 1 <br /> j(5) Date of Driveway Construction: s pie N c of I ? 7 ( <br /> 1 The undersigned hereby applies for a driveway permit at the <br /> bove location, and consents to said construction according to <br /> specifications established by the Town, a set forth in the approval <br /> f the permit. / <br /> r <br /> Name: s .c,t,��--1 w- <br /> Addr ss: / n.?3-ST 4,tr s <br /> 17 C) fA L 4 I - <br /> Telephon No. : t.. . ' a <br /> - DRIVEWAY PERMIT - <br /> Town of Verona, Dane County, Wisconsin <br /> / AN 'R E D /:N R u i a is hereby(ranters(denisdj a <br /> ermit for construction of a driveway at the location set forth in <br /> he preceding application on the following conditions: <br /> 1) Date of Completion: �j p/2/h� t o r /, ,iii <br /> c/ I <br /> 2) Specifications of Culvert: 15 // x 3o :f__ , -'--s <br /> 1 <br /> (3) Width of Driveway: A C I <br /> (4) Grading Requirements: P J' (V E lwA y ,S'%-/14 L L. AP p/4).1 LK <br /> R/verSi1 A.5 h(l=AR L.tVrL 4S f?oSsit3Lr= PA 1Z AT <br /> 'C 4:"4 •Sr /4 CAIZ LF_ NGT4. <br /> (5) Special Remarks: <br /> NcNF <br /> The foregoing permit is issued according to the foregoing <br /> Conditions only, and any variance shall be only with approval of <br /> the Town Board. �i �j <br /> D TED: 14C- g - 9'0 <br /> ,i a,e,4,,4 1 /l; iltLki it/ <br /> Town Chairman k <br />